中西医结合治疗肾上腺肿瘤术后皮质功能减退的临床疗效

Combination of Traditional Chinese and Western Medicine in Treatment of Adrenal Insufficiency after Adrenal Tumor Surgery

目的:探讨分析中西医结合方法对肾上腺肿瘤术后引起的肾上腺皮质功能减退进行治疗的临床疗效。方法:选择2014年5月—2015年8月期间医院收治的肾上腺肿瘤术后皮质功能不足患者共68例,将其采用随机数字表的方法分为对照组和观察组,每组各34例。对照组患者给予西医进行治疗,观察组患者在对照组治疗的基础上给予中西医结合进行治疗,对比两组患者的临床疗效及不良反应情况。结果:观察组患者总有效率达97.06%,不良反应发生率为8.82%;对照组患者总有效率为73.53%,不良反应发生率为29.41%,差异具有统计意义(P<0.05)。经治疗后,观察组患者晨8 h血浆皮质醇、晨8 h血浆促肾上腺皮质激素(ACTH)、24 h尿游离皮质醇(UFC)、17-羟皮质类固醇(17-OHCS)及17-酮类固醇(17-KS)含量值显著高于对照组(P<0.05)。结论:中西医结合治疗肾上腺肿瘤术后皮质功能不足,起效迅速、安全,且不良反应轻微,可应用于医学领域,也对于气阴两虚型糖尿病肾病等患者具有临床意义,值得临床推广应用。

Objective： To explore the clinical effect of combined treatment of traditional Chinese and Western medicine for adrenal insufficiency. Methods： Sixty-eight cases of adrenal insufficiency in our hospital from May 2014 to August2015 were selected and randomly divided into control group and observation group,34 cases in each group. Patients in the control group were given western medicine treatment and the observation group treated with combination of traditional Chinese and Western medicine on the basis of the control group and the clinical efficacy and adverse reaction of the two groups were compared. Results： The total effective rate of observation group was 97. 06% and the incidence of adverse reactions was 8. 82%. The control group＇s total effective rate was 73. 53% and adverse reaction rate was 29. 41%. The difference was statistically significant（ P〈0. 05）. After treatment,observation group＇s morning 8 h plasma cortisol,8 h morning plasma promote adrenal cortical hormone（ ACTH）,24 h urinary free cortisol（ UFC）,17 hydroxycorticosteroids,（ 17-OHCS） and 17 Ketosteroid（ 17-KS） content values were significantly higher than those of the control group（ P〈0. 05）. Conclusion： Combination of TCM and Western medicine for cortical function deficiency after adrenal tumors surgery has rapid onset,safety and slight adverse reaction. It also has clinical significance in the patients with deficiency of both qi and Yin type of diabetic nephropathy,worthy of clinical application.